The Lived Experience of a Patient While Receiving Treatment on an Orthopedic Unit After a Hip Fracture: Integrating Research and Theory to Improve Patient Care

A hip fracture is a devastating injury for an older person, often resulting in long-term or permanent loss of mobility and independence. Although research has been conducted on various aspects of hip fractures, little research has described the experience of a patient with a hip fracture. This phenomenological study explored the lived experience of a patient receiving treatment on an orthopedic unit after a hip fracture. A purposeful sample of two participants who were hospitalized at Saint Mary\u27s Hospital following a hip fracture were interviewed after surgical repair of the fracture. The interviews were analyzed using Giorgi\u27s descriptive phenomenology. The results of this study will provide a better understanding of the experience of the patient with a hip fracture. Orthopedic nurses and nurse managers will use this information to improve patient care

Evolutionary Clustering of Apprentices' Self- Regulated Learning Behavior in Learning Journals

Learning journals are increasingly used in vocational education to foster self-regulated learning and reflective learning practices. However, for many apprentices, documenting working experiences is a difficult task. In this article, we profile apprentices' learning behavior in an online learning journal. Based on a pedagogical framework, we propose a novel multistep clustering pipeline that integrates different learning dimensions into a combined profile. Specifically, the profiles are described in terms of effort, consistency, regularity, help-seeking behavior, and quality of the written entries. Our results on two populations of chef apprentices (183 apprentices) interacting with an online learning journal (over 121K entries) show that our pipeline captures changes in learning patterns over time and yields interpretable profiles that can be related to academic performance. The obtained profiles can be used as a basis for personalized interventions, with the ultimate goal of improving the apprentices' learning experience

New Insights Into the Regulation of Natural-Killer Group 2 Member D (NKG2D) and NKG2D-Ligands: Endoplasmic Reticulum Stress and CEA-Related Cell Adhesion Molecule 1

Natural-killer group 2 member D (NKG2D) is a well-characterized activating receptor expressed by natural killer (NK) cells, NKT cells, activated CD8+ T cells, subsets of γδ+ T cells, and innate-like T cells. NKG2D recognizes multiple ligands (NKG2D-ligands) to mount an innate immune response against stressed, transformed or infected cells. NKG2D-ligand surface expression is tightly restricted on healthy cells through transcriptional and post-transcriptional mechanisms, while transformed or infected cells express the ligands as a danger signal. Recent studies have revealed that unfolded protein response (UPR) pathways during endoplasmic reticulum (ER) stress result in up-regulation of ULBP-related protein via the PERK-ATF4-CHOP pathway, which can be linked to the pathogenesis of autoimmune diseases. Transformed cells however possess mechanisms to escape NKG2D-mediated immune surveillance, such as upregulation of carcinoembryonic antigen (CEA)-related cell adhesion molecule 1 (CEACAM1), a negative regulator of NKG2D-ligands. In this review, we discuss mechanisms of NKG2D-ligand regulation, with a focus on newly discovered mechanisms that promote NKG2D-ligand expression on epithelial cells, including ER stress, and mechanisms that suppress NKG2D-ligand mediated killing of cancer cells, namely by co-expression of CEACAM1.Wellcome Trust Senior Investigator Award 106260/Z/14/Z, the European Research Council HORIZON2020/ERC grant no. 648889 (A.K.

Potential tumour doubling time: determination of Tpot for various canine and feline tumours

Spontaneous tumours in dogs and cats are an excellent model for clinical human research, such as in developing proton conformation radiotherapy for humans. The kinetics of tumour cells can be used effectively to predict prognosis and response to therapy in patients with tumours. Knowledge of the kinetic parameters in these tumours is therefore important. In the present study the kinetic parameters evaluated included the labelling index (LI), relative movement (RM), mitotic index (MI), and potential doubling time (Tpot). These parameters were determined using in vivo labelling with bromodeoxyuridine, flow cytometry and histological preparation. Samples were obtained and evaluated from 72 dogs and 20 cats, presenting as patients in our clinic. Within the groups of epithelial and mesenchymal tumours from dogs and cats, the kinetic parameters LI, RM and MI were compared with Tpot. Significant correlations were observed for the comparison Tpot and LI. No correlation was found between Tpot and R

A new paradigm of quantifying ecosystem stress through chemical signatures

Stress-induced emissions of biogenic volatile organic compounds (VOCs) from terrestrial eco- systems may be one of the dominant sources of VOC emissions worldwide. Understanding the ecosystem stress response could reveal how ecosystems will respond and adapt to climate change and, in turn, quan- tify changes in the atmospheric burden of VOC oxidants and secondary organic aerosols. Here, we argue, based on preliminary evidence from several opportunistic measurement sources, that chemical signatures of stress can be identified and quantified at the ecosystem scale. We also outline future endeavors that we see as next steps toward uncovering quantitative signatures of stress, including new advances in both VOC data collection and analysis of "big data.

A Mark in Time Saves Nein

A method for predicting political interactions and policy outcomes based on two political theorems is presented and illustrated with an examination of the decision to merge the two German currencies. Political perceptions and actions are anticipated by combining the substantive knowledge of area experts with the theoretical insights embedded in the median voter theorem and a monotonicity theorem that links expectations to probabilistic statements of action. The proposed model has proven accurate about 90 percent of the time. The proposed forecasting method identifies a sequential strategy that may have been followed by Chancellor Kohl in forging the coalition needed to merge successfully the two German currencies. Using comparative statics, the analysis suggests how subtle and sophisticated Chancellor Kohl had to be to succeed in getting the policy outcome he desired despite stiff opposition.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66924/2/10.1177_019251219201300106.pd

The Enabler: A concept for a lunar work vehicle

The Enabler is an earthbound prototype designed to model an actual lunar work vehicle and is able to perform many of the tasks that might be expected of a lunar work vehicle. The vehicle will be constructed entirely from parts made by students and from standard stock parts. The design utilizes only four distinct chassis pieces and sixteen moving parts. The Enabler has non-orthogonal articulating joints that give the vehicle a wide range of mobility and reduce the total number of parts. Composite wheels provide the primary suspension system for the vehicle