Preventing Surgical Site Infections by Utilizing CHG Wipes for Preoperative Skin Preparation

Abstract The Clinical Nurse Leader project took place at a 106-bed community hospital in Washington. The microsystem has five operating rooms where they provide outpatient, and inpatient surgical procedures. The goal of this project is to reduce and sustain a near zero number of surgical site infections by implementing the use of a no rinse 2% CHG cloth in the surgical patient. The specific aim of the project is to reduce the rate of SSIs by 80% by December 31st, 2015. Due to a lack of a standardized care, specifically designed for the prevention of SSIs, the microsystem is experiencing a higher rate of SSIs than desired. Methods utilized in this project were data of the current SSI rates for fiscal year 2015, and unit assessment. The data revealed that the microsystem had incurred a total of 12 SSIs, which cost a total of $249,420 to treat. The cost of implementation of the 2$12,168. The pre-intervention results found variations in preoperative skin preparation, and a lack of compliance. Interventions included the standardization of preoperative skin process, developing education for staff and patients, and determining how product would be dispersed to patients. The specific aim goals will not be actualized until data analysis is completed on December 31st, 2015

Nebulized PPARγ agonists: a novel approach to augment neonatal lung maturation and injury repair in rats.

BackgroundBy stimulating lipofibroblast maturation, parenterally administered peroxisome proliferator-activated receptor γ (PPARγ) agonists promote lung homeostasis and injury repair in the neonatal lung. In this study, we determined whether PPARγ agonists could be delivered effectively via nebulization to neonates, and whether this approach would also protect against hyperoxia-induced lung injury.MethodsOne-day old Sprague-Dawley rat pups were administered PPARγ agonists rosiglitazone (RGZ, 3 mg/kg), pioglitazone (PGZ, 3 mg/kg), or the diluent, via nebulization every 24 h; animals were exposed to 21% or 95% O2 for up to 72 h. Twenty-four and 72 h following initial nebulization, the pups were sacrificed for lung tissue and blood collection to determine markers of lung maturation, injury repair, and RGZ and PGZ plasma levels.ResultsNebulized RGZ and PGZ enhanced lung maturation in both males and females, as evidenced by the increased expression of markers of alveolar epithelial and mesenchymal maturation. This approach also protected against hyperoxia-induced lung injury, since hyperoxia-induced changes in bronchoalveolar lavage cell and protein contents and lung injury markers were all blocked by nebulized PGZ.ConclusionNebulized PPARγ agonist administration promotes lung maturation and prevents neonatal hyperoxia-induced lung injury in both males and females

Antioxidative Activities of Alfalfa and Timothy Varieties

The term functional foods is often used as a generic description for the beneficial effects of ingested foods that go beyond their traditional nutritive value (Bauman et al., 2001). Milk and dairy products are important dietary sources of nutrients, providing energy, high quality protein, and a variety of vitamins and minerals. Recent research has focused on altering the fat and protein content of milk and other dairy products in order to improve their nutrient content to more aptly reflect current dietary recommendations and trends. As a result, additional focus is being given to designing foods that have beneficial effects on human health. This study was carried out to investigate the antioxidative activities of forages grown in Korea

Delayed degradation of chlorophylls and photosynthetic proteins in Arabidopsis autophagy mutants during stress-induced leaf yellowing

Under mild abiotic-stress conditions, Arabidopsis atg mutants showed a functional stay-green phenotype which is probably caused by the lack of chloroplastic autophagy and the retrograde regulation of senescence-associated gene expressio

Yield and Nutritive Value of Heading and Headless Sorghum x Sudangrass Hybrids in Response to Cutting Frequency

Summer annual forages contribute greatly toward solving the problem of roughage supply for cattle in Korea. These forages support high levels of dairy and beef production during hot summer months when the quality and production of perennial herbage decreases due to unfavourable climatic conditions (Olson, 1971). This study investigated the effects of cutting frequency on dry matter (DM) yield and nutritive value of heading versus headless varieties of sorghum x sudangrass hybrid

Arabidopsis ABCG34 contributes to defense against necrotrophic pathogens by mediating the secretion of camalexin

Plant pathogens cause huge yield losses. Plant defense often depends on toxic secondary metabolites that inhibit pathogen growth. Because most secondary metabolites are also toxic to the plant, specific transporters are needed to deliver them to the pathogens. To identify the transporters that function in plant defense, we screened Arabidopsis thaliana mutants of full-size ABCG transporters for hypersensitivity to sclareol, an antifungal compound. We found that atabcg34 mutants were hypersensitive to sclareol and to the necrotrophic fungi Alternaria brassicicola and Botrytis cinerea. AtABCG34 expression was induced by A. brassicicola inoculation as well as by methyl-jasmonate, a defense-related phytohormone, and AtABCG34 was polarly localized at the external face of the plasma membrane of epidermal cells of leaves and roots. atabcg34 mutants secreted less camalexin, a major phytoalexin in A. thaliana, whereas plants overexpressing AtABCG34 secreted more camalexin to the leaf surface and were more resistant to the pathogen. When treated with exogenous camalexin, atabcg34 mutants exhibited hypersensitivity, whereas BY2 cells expressing AtABCG34 exhibited improved resistance. Analyses of natural Arabidopsis accessions revealed that AtABCG34 contributes to the disease resistance in naturally occurring genetic variants, albeit to a small extent. Together, our data suggest that AtABCG34 mediates camalexin secretion to the leaf surface and thereby prevents A. brassicicola infection.117Ysciescopu

An exploration of grip force regulation with a low-impedance myoelectric prosthesis featuring referred haptic feedback

Abstract Background Haptic display technologies are well suited to relay proprioceptive, force, and contact cues from a prosthetic terminal device back to the residual limb and thereby reduce reliance on visual feedback. The ease with which an amputee interprets these haptic cues, however, likely depends on whether their dynamic signal behavior corresponds to expected behaviors—behaviors consonant with a natural limb coupled to the environment. A highly geared motor in a terminal device along with the associated high back-drive impedance influences dynamic interactions with the environment, creating effects not encountered with a natural limb. Here we explore grasp and lift performance with a backdrivable (low backdrive impedance) terminal device placed under proportional myoelectric position control that features referred haptic feedback. Methods We fabricated a back-drivable terminal device that could be used by amputees and non-amputees alike and drove aperture (or grip force, when a stiff object was in its grasp) in proportion to a myoelectric signal drawn from a single muscle site in the forearm. In randomly ordered trials, we assessed the performance of N=10 participants (7 non-amputee, 3 amputee) attempting to grasp and lift an object using the terminal device under three feedback conditions (no feedback, vibrotactile feedback, and joint torque feedback), and two object weights that were indiscernible by vision. Results Both non-amputee and amputee participants scaled their grip force according to the object weight. Our results showed only minor differences in grip force, grip/load force coordination, and slip as a function of sensory feedback condition, though the grip force at the point of lift-off for the heavier object was significantly greater for amputee participants in the presence of joint torque feedback. An examination of grip/load force phase plots revealed that our amputee participants used larger safety margins and demonstrated less coordination than our non-amputee participants. Conclusions Our results suggest that a backdrivable terminal device may hold advantages over non-backdrivable devices by allowing grip/load force coordination consistent with behaviors observed in the natural limb. Likewise, the inconclusive effect of referred haptic feedback on grasp and lift performance suggests the need for additional testing that includes adequate training for participants.http://deepblue.lib.umich.edu/bitstream/2027.42/116041/1/12984_2015_Article_98.pd

THE TRANSFORMATIVE POTENTIAL OF CREATIVE ART PRACTICES IN THE CONTEXT OF INTERDISCIPLINARY RESEARCH

A growing body of literature addressing the need for educational innovations has also stressed the value of interdisciplinary approaches that incorporate art into teaching and learning. This paper aims to extend educators??? understanding of art???science interactions by presenting an empirical study that explores a unique art residency program created on the campus of a university that specializes in science and technology. The study reviews the art practices of three contemporary artists who participated in a program developed in conjunction with an interdisciplinary research project seeking ways to build an ecologically sustainable community and operated by a renewable energy resource-based economic system. Data that include observations, artist talks, and in-person interviews were collected from multiple sources during the residency to understand the distinguished processes involved in the development of individual art projects. A follow-up cross-case analysis revealed a few notable characteristics: connecting art with life through waste recycling, process-oriented practices highlighting resource circulation, and creating value using bricolage strategies. Regarding educational implications, discussions centered upon the potential transformational space identified from the creative art practices in the context of interdisciplinary research

Twin reversed arterial perfusion (TRAP) sequence in association with VACTERL association: a case report

<p>Abstract</p> <p>Introduction</p> <p>Twin reversed arterial perfusion (TRAP) sequence is a rare complication of multiple pregnancy caused by defects in early embryogenesis. The pump twin supplies the acardiac recipient twin with blood, and although the pump twin is usually structurally normal, congenital anomalies have sometimes been reported. We report a unique case of twin reversed arterial perfusion sequence with a prenatal diagnosis of VACTERL association in the surviving pump twin.</p> <p>Case presentation</p> <p>A 24-year-old Caucasian woman presented at 11 weeks' gestation with a monochorionic, monoamniotic twin pregnancy. A reversed arterial flow was noted on a Doppler imaging study coming from the larger, apparently normal twin to the smaller, grossly abnormal twin, and a diagnosis of twin reversed arterial perfusion sequence was made. Cardiac activity was undetectable in the recipient twin by 16 weeks' gestation. Further detailed assessment at 18 weeks' gestation revealed multiple congenital anomalies of the surviving pump twin, in keeping with a diagnosis of VACTERL association. A live infant girl was delivered at 39 weeks by elective cesarean section. She underwent extensive surgery with subsequent normal development at the age of two years.</p> <p>Conclusion</p> <p>The co-existence of two rare and complex conditions in this unique case raises interesting questions about the role of early defects in embryogenesis and their subsequent effects on fetal development. This case also highlights the importance of prenatal diagnosis of major congenital anomalies to the plan treatment, reduce morbidity and aid the survival of affected children.</p

The impact of factors beyond Breslow depth on predicting sentinel lymph node positivity in melanoma

BACKGROUND. In addition to Breslow depth, the authors previously described how increasing mitotic rate and decreasing age predicted sentinel lymph node (SLN) metastases in patients with melanoma. The objectives of the current study were to verify those previous results and to create a prediction model for the better selection of which patients with melanoma should undergo SLN biopsy. METHODS. The authors reviewed 1130 consecutive patients with melanoma in a prospective database who underwent successful SLN biopsy. After eliminating patients aged <16 years and patients who had melanomas that measured <1 mm, 910 remaining patients were reviewed for clinical and pathologic features and positive SLN status. Univariate association of patient and tumor characteristics with positive SLN status was explored by using standard logistic regression techniques, and the best multivariate model that predicted lymph node metastases was constructed by using a backward stepwise-elimination technique. RESULTS. The characteristics that were associated significantly with lymph node metastasis were angiolymphatic invasion, the absence of regression, increasing mitotic rate, satellitosis, ulceration, increasing Breslow depth, decreasing age, and location (trunk or lower extremity compared with upper extremity or head/neck). Previously reported interactions between mitotic rate and age and between Breslow depth and age were confirmed. The best multivariate model included patient age (linear), angiolymphatic invasion, the number of mitoses (linear), the interaction between patient age and the number of mitoses, Breslow depth (linear), the interaction between patient age and Breslow depth, and primary tumor location. CONCLUSIONS. Younger age, increasing mitotic rate (especially in younger patients), increasing Breslow depth (especially in older patients), angiolymphatic invasion, and trunk or lower extremity location of the primary tumor were associated with a greater likelihood of positive SLN status. The current results support the use of factors beyond Breslow depth to determine the risk of positive SLN status in patients with cutaneous melanoma. Cancer 2007. © 2006 American Cancer SocietyPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/55870/1/22382_ftp.pd