Designing Dental Student Portfolios to Assess Performance

The purpose of this poster is to share a project developed by Marquette University’s liaisons to the American Dental Education Association’s Commission on Change and Innovation in Dental Education with others interested in learning about the use of portfolios to assess the quality of student performance in dental school. Sample components from the pilot portfolios will be integrated into the poster to provide participants with a view from portfolio design to completion. Portfolios are becoming a more common method of assessing the quality of student performance in health professions education. Portfolios can assist in documenting evidence of specific competencies at the student level and also serve as a longitudinal measure of a student’s development

Exploring the use of zircon geochronology as an indicator of Laurentide Ice Sheet till provenance, Indiana, USA

A pilot study was designed to evaluate the potential of zircon geochronology as a provenance indicator of till from the Lake Michigan, Saginaw, and Huron-Erie Lobes of the Laurentide Ice Sheet. Based on existing ice flow-path models, we hypothesized that till from each lobe would have different zircon age population distributions because the lobes originated from regions of the Canadian Shield with different bedrock ages. After correcting for zircon fertility, the majority of grains in all till samples are 1600–950 Ma, with ~30 % of ages >2500 Ma. This similarity means that till from the three lobes cannot be clearly differentiated based on their zircon populations. The dominant ages found and the homogeneity of distributions in the till indicates a non-Shield source and, instead, reflect an origin from some combination of underlying till and sedimentary bedrock in the Great Lakes region. Even though the datasets are small, the tills have similarities to zircon distributions in Michigan Basin rocks. This implies that a substantial fraction of zircon in till was not transported long distances from the Canadian Shield. Although zircon ages are not distinct between tills, the method provides a novel application to understand Laurentide Ice Sheet glacial erosion and transport

The End Magnets of the Ifusp Race-track Microtron Booster

The end magnets of the IFUSP race-track microtron booster, second stage of the electron accelerator under construction at the Linear Accelerator Laboratory, are presented. They deflect, focus and return the beam to the accelerating section. Details about the project are discussed, Poisson code was used to give the final geometry of the end magnets. The end magnets incorporate auxiliary pole pieces (clamps) which create a reverse fringe field region that avoids the beam vertical defocusing and reduces the horizontal displacement produced by extended fringe fields (EFF). The small gap height used for the clamps provided reverse field distributions with fringe fields of short extensions, avoiding the traditional use of inactive clamps. Measurements and calculations concerning particle trajectories and reverse field distribution are presented. The floating wire technique, employing an original procedure to register orbits, was used to corroborate the calculated beam trajectories and represents a good experimental option in the lack of the accelerator beam. The experimental results showed agreement of about 0.1% with the calculations

Geometry of River Networks II: Distributions of Component Size and Number

The structure of a river network may be seen as a discrete set of nested sub-networks built out of individual stream segments. These network components are assigned an integral stream order via a hierarchical and discrete ordering method. Exponential relationships, known as Horton's laws, between stream order and ensemble-averaged quantities pertaining to network components are observed. We extend these observations to incorporate fluctuations and all higher moments by developing functional relationships between distributions. The relationships determined are drawn from a combination of theoretical analysis, analysis of real river networks including the Mississippi, Amazon and Nile, and numerical simulations on a model of directed, random networks. Underlying distributions of stream segment lengths are identified as exponential. Combinations of these distributions form single-humped distributions with exponential tails, the sums of which are in turn shown to give power law distributions of stream lengths. Distributions of basin area and stream segment frequency are also addressed. The calculations identify a single length-scale as a measure of size fluctuations in network components. This article is the second in a series of three addressing the geometry of river networks.Comment: 16 pages, 13 figures, 4 tables, Revtex4, submitted to PR

Failure of physiologic transformation of spiral arteries, endothelial and trophoblast cell activation, and acute atherosis in the basal plate of the placenta

BACKGROUND: Failure of physiologic transformation of spiral arteries has been reported in preeclampsia, fetal growth restriction, fetal death, and spontaneous preterm labor with intact or ruptured membranes. Spiral arteries with failure of physiologic transformation are prone to develop atherosclerotic-like lesions of atherosis. There are striking parallels between preeclampsia and atherosclerotic disease, and between lesions of atherosis and atherosclerosis. Endothelial activation, identified by intercellular adhesion molecule-1 expression, is present in atherosclerotic-like lesions of heart transplantation, and is considered a manifestation of rejection. Similarly, endothelial activation/dysfunction has been implicated in the pathophysiology of atherosclerosis and preeclampsia. Intercellular adhesion molecule-1-overexpressing-activated endothelial cells are more resistant to trophoblast displacement than nonactivated endothelium, and may contribute to shallow spiral artery trophoblastic invasion in obstetrical syndromes having failure of physiologic transformation. OBJECTIVE: We sought to determine whether failure of spiral artery physiologic transformation was associated with activation of interstitial extravillous trophoblasts and/or spiral artery endothelium and presence of acute atherosis in the placental basal plate. STUDY DESIGN: A cross-sectional study of 123 placentas (19-42 weeks' gestation) obtained from normal pregnancies (n = 22), preterm prelabor rupture of membranes (n = 26), preterm labor (n = 23), preeclampsia (n = 27), intrauterine fetal death (n = 15), and small for gestational age (n = 10) was performed. Failure of spiral artery physiologic transformation and presence of cell activation was determined using immunohistochemistry of placental basal plates containing a median of 4 (minimum: 1; maximum: 9) vessels per placenta. Endothelial/trophoblast cell activation was defined by the expression of intercellular adhesion molecule-1. Investigators examining microscopic sections were blinded to clinical diagnosis. Pairwise comparisons among placenta groups were performed with Fisher exact test and Wilcoxon rank sum test using a Bonferroni-adjusted level of significance (.025). RESULTS: We found that 87% (94/108) of placentas having spiral arteries with failure of physiologic transformation (actin-positive and cytokeratin-negative) in the basal plate, and 0% (0/15) of placentas having only spiral arteries with complete physiologic transformation (cytokeratin-positive and actin-negative), had arterial endothelial and/or interstitial extravillous trophoblasts reactive with the intercellular adhesion molecule-1 activation marker (P < .001). A significant correlation (R2 = 0.84) was found between expression of spiral artery endothelial and interstitial extravillous trophoblast intercellular adhesion molecule-1 (P < .001) in activated placentas. Lesions of atherosis were found in 31.9% (30/94) of placentas with complete and/or partial failure of physiologic transformation of spiral arteries that were intercellular adhesion molecule-1-positive, in none of the 14 placentas with failure of physiologic transformation that were intercellular adhesion molecule-1-negative, and in none of the 15 placentas with complete spiral artery physiologic transformation without failure (P = .001). All placentas (30/30, 100%) with atherosis were identified in placentas having concomitant spiral artery endothelial and interstitial extravillous trophoblast activation. CONCLUSION: Failure of spiral artery physiologic transformation in the placental basal plate is associated with interstitial extravillous trophoblast and arterial endothelial activation along with increased frequency of spiral artery atherosis. These findings may be used to improve the characterization of different disorders of the placental bed such as in refining the existing tools for the early prediction of risk for preterm, preeclamptic, and other abnormal pregnancies

Engaging patients and clinicians through simulation: rebalancing the dynamics of care

This paper proposes simulation-based enactment of care as an innovative and fruitful means of engaging patients and clinicians to create collaborative solutions to healthcare issues. This use of simulation is a radical departure from traditional transmission models of education and training. Instead, we frame simulation as co-development, through which professionals, patients and publics share their equally (though differently) expert perspectives. The paper argues that a process of participatory design can bring about new insights and that simulation offers understandings that cannot easily be expressed in words. Drawing on more than a decade of our group’s research on simulation and engagement, the paper summarises findings from studies relating to clinician-patient collaboration and proposes a novel approach to address the current need. The paper outlines a mechanism whereby pathways of care are jointly created, shaped, tested and refined by professionals, patients, carers and others who are affected and concerned by clinical care

Spatial distribution, determinants and trends of full vaccination coverage in children aged 12-59 months in Peru: A subanalysis of the Peruvian Demographic and Health Survey

Objective To assess the spatial distribution, trends and determinants of crude full vaccination coverage (FVC) in children aged 12-59 months between 2010 and 2019 in Peru. Design, setting and analysis A cross-sectional study based on the secondary data analysis of the 2010 and 2019 Peruvian Demographic and Health Surveys (DHSs) was conducted. Logit based multivariate decomposition analysis was employed to identify factors contributing to differences in FVC between 2010 and 2019. The spatial distribution of FVC in 2019 was evaluated through spatial autocorrelation (Global Moran's I), ordinary kriging interpolation (Gaussian process regression) and Bernoulli-based purely spatial scan statistic. Outcome measure FVC, as crude coverage, was defined as having completely received BCG; three doses of diphtheria, pertussis, and tetanus, and polio vaccines; and measles vaccine by 12 months of age. Participants A total of 5 751 and 14 144 children aged 12-59 months from 2010 and 2019 DHSs, respectively, were included. Results FVC increased from 53.62% (95% CI 51.75% to 55.49%) in 2010 to 75.86% (95% CI 74.84% to 76.85%) in 2019. Most of the increase (70.39%) was attributable to differences in coefficients effects. Family size, visit of health workers in the last 12 months, age of the mother at first delivery, place of delivery and antenatal care follow-up were all significantly associated with the increase. The trend of FVC was non-linear and increased by 2.22% annually between 2010 and 2019. FVC distribution was heterogeneous at intradepartmental and interdepartmental level. Seven high-risk clusters of incomplete coverage were identified. Conclusions Although FVC has increased in Peru, it still remains below the recommended threshold. The increase of FVC was mainly attributed to the change in the effects of the characteristics of the population. There was high heterogeneity across Peruvian regions with the presence of high-risk clusters. Interventions must be redirected to reduce these geographical disparities.Revisión por pare

Biological characteristics of Trichospilus diatraeae (Hymenoptera: Eulophidae) are influenced by the number of females exposed per pupa of Tenebrio molitor (Coleoptera: Tenebrionidae).

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Amplification Properties of Femtosecond Laser-Written Er3+/Yb3+ Doped Waveguides in a Tellurium-Zinc Glass

We report on the fabrication and characterization of active waveguides in a TeO2-ZnO glass sample doped with Er3+/Yb3+ fabricated by direct laser writing with a femtosecond laser delivering 150 fs pulses at 1 kHz repetition rate. The waveguides exhibit an internal gain of 0.6 dB/cm at 1535 nm, thus demonstrating the feasibility of active photonics lightwave circuits and lossless components in such a glass composition

Reducing care-resistant behaviors during oral hygiene in persons with dementia

Abstract Background Nursing home residents with dementia are often dependent on others for mouth care, yet will react with care-resistant behavior when receiving assistance. The oral health of these elders deteriorates in the absence of daily oral hygiene, predisposing them to harmful systemic problems such as pneumonia, hyperglycemia, cardiac disease, and cerebral vascular accidents. The purpose of this study is to determine whether care-resistant behaviors can be reduced, and oral health improved, through the application of an intervention based on the neurobiological principles of threat perception and fear response. The intervention, called Managing Oral Hygiene Using Threat Reduction, combines best mouth care practices with a constellation of behavioral techniques that reduce threat perception and thereby prevent or de-escalate care-resistant behaviors. Methods/Design Using a randomized repeated measures design, 80 elders with dementia from 5 different nursing homes will be randomized at the individual level to the experimental group, which will receive the intervention, or to the control group, which will receive standard mouth care from research team members who receive training in the proper methods for providing mouth care but no training in resistance recognition or prevention/mediation. Oral health assessments and care-resistant behavior measurements will be obtained during a 7-day observation period and a 21-day intervention period. Individual growth models using multilevel analysis will be used to estimate the efficacy of the intervention for reducing care-resistant behaviors in persons with dementia, and to estimate the overall efficacy of the intervention using oral health outcomes. Activity-based costing methods will be used to determine the cost of the proposed intervention. Discussion At the conclusion of this study, the research team anticipates having a proven intervention that prevents and reduces care-resistant within the context of mouth care. Long-term objectives include testing the effect of the intervention on systemic illnesses among persons with dementia; examining the transferability of this intervention to other activities of daily living; and disseminating threat reduction interventions to nursing home staff, which may radically change the manner in which care is provided to persons with dementia. Trial Registration ClinicalTrials.gov: NCT01363258http://deepblue.lib.umich.edu/bitstream/2027.42/112778/1/12903_2011_Article_198.pd