Factors that impact two-year college attendance and program enrollment among community college students

Research suggests that numerous factors affect community college attendance. Therefore, when students choose to attend community college, those factors often are key aspects of their decisions. Nonetheless, limited information exists that identifies which particular traits affect community college choice and how the background characteristics of students impact those qualities. Hence, this study evaluates how well academic and institutional factors as well as the character traits of students influence their decision to attend community college. The purpose of this study was to conduct a path analysis assessment of the academic and institutional factors that impact community college attendance and program enrollment. Data were collected from the 2005 Freshman Survey administered by the Cooperative Institutional Research Program (CIRP). Path analysis modeling was used to analyze these data to determine which academic and institutional factors influence community college choice and to see how background characteristics moderate those traits. The results of this study yielded several positive correlations and, therefore, indicated significant relationships between community colleges and academic, institutional, and background characteristics and their ability to successfully predict community college attendance. This study also revealed that both academic and institutional factors affect community college attendance. However, it was evident that regression models with certain academic factors predicted community college attendance more accurately, where models with institutional factors possessed more statistically significant factors. Further, this study revealed that background character traits did not affect community college choice as much as previously assumed. Hence, the ability to predict community college attendance should be enhanced as a result of the findings of this study

Kidney and Pancreas Transplantation in the United States, 1998–2007: Access for Patients with Diabetes and End-Stage Renal Disease

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73092/1/j.1600-6143.2009.02566.x.pd

Association of Center Volume with Outcome After Liver and Kidney Transplantation

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73934/1/j.1600-6143.2004.00462.x.pd

Does Hospital Electronic Medical Record Adoption Lead To Upcoding or More Accurate Coding?

Abstract This paper seeks to evaluate whether the adoption of electronic medical records (EMRs) leads to upcoding for hospitalized Medicare patients, defined as categorizing a condition as more serious than justified in order to inflate bills, or more accurate coding. We use a triple difference: (1) between EMR and non-EMR hospitals; (2) before and after the 2007 Medicare payment reform, which made obtaining high payments harder; and (3) between medical and surgical admissions. For medical admissions, we find that the interaction of Medicare payment reform and EMR hospitals leads to higher codes, regardless of the financial incentive to upcode. For surgical admissions, we find no significant effect. While there is no evidence of upcoding, EMRs lead to higher billing by increasing the accuracy of coding for medical admissions

Analytical approaches for transplant research

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73605/1/j.1600-6135.2004.00402.x.pd

Guideline attainment and morbidity/mortality rates in a large cohort of European hemodialysis patients (EURODOPPS)

International audienceBackground. Haemodialysis patients experience a wide variety of intermediate complications, such as anaemia, hypertension and mineral bone disease (MBD). We aimed to assess the risk of death and hospital admissions as a function of the simultaneous attainment of different guideline targets (for hypertension, anaemia andMBD) in a large European cohort of dialysis patients. Methods. EURODOPPS is part of the Dialysis Outcomes and Practice Patterns Study (DOPPS) international, prospective cohort study of adult, in-centre haemodialysis patients for whom clinical data are extracted from medical records. In the present analysis, 6317 patients from seven European countries were included between 2009 and 2011. The percentages of patients treated according to the international guidelines on anaemia, hypertension and MBD were determined. The overall degree of guideline attainment was considered to be high if four or all five of the evaluated targets were attained, moderate if two or three targets were attained, and low if fewer than two targets were attained. Fully adjusted multivariate Cox models were used to investigate the relationship of target attainment with mortality and first hospital admission. Results. At baseline, the degree of target attainment was low in 1751 patients (28%), moderate in 3803 (60%) and high in 763 (12%). In the fully adjusted model using time-dependent covariates, low attainment was associated with higher all-cause mortality [hazard ratio (95% confidence interval) = 1.19 (1.05-1.34)] and high attainment was associated with lower all-cause mortality [0.82 (0.68-0.99)]. In a similarmodel that additionally accounted for death as a competing risk, low and high attainments were not associated with hospital admission. Conclusion. In a large international cohort of dialysis patients, we have shown that more stringent application of guidelines is associated with lower mortality

Impact of PNKP mutations associated with microcephaly, seizures and developmental delay on enzyme activity and DNA strand break repair

Microcephaly with early-onset, intractable seizures and developmental delay (MCSZ) is a hereditary disease caused by mutations in polynucleotide kinase/phosphatase (PNKP), a DNA strand break repair protein with DNA 5'-kinase and DNA 3'-phosphatase activity. To investigate the molecular basis of this disease, we examined the impact of MCSZ mutations on PNKP activity in vitro and in cells. Three of the four mutations currently associated with MCSZ greatly reduce or ablate DNA kinase activity of recombinant PNKP at 30°C (L176F, T424Gfs48X and exon15Δfs4X), but only one of these mutations reduces DNA phosphatase activity under the same conditions (L176F). The fourth mutation (E326K) has little impact on either DNA kinase or DNA phosphatase activity at 30°C, but is less stable than the wild-type enzyme at physiological temperature. Critically, all of the MCSZ mutations identified to date result in ∼10-fold reduced cellular levels of PNKP protein, and reduced rates of chromosomal DNA strand break repair. Together, these data suggest that all four known MCSZ mutations reduce the cellular stability and level of PNKP protein, with three mutations likely ablating cellular DNA 5'-kinase activity and all of the mutations greatly reducing cellular DNA 3'-phosphatase activity

Catheter‐related Infection and Septicemia: Impact of Seasonality and Modifiable Practices from the DOPPS

Hemodialysis (HD) catheter‐related infection (CRI) and septicemia contribute to adverse outcomes. The impact of seasonality and prophylactic dialysis practices during high‐risk periods remain unexplored. This multicenter study analyzed DOPPS data from 12,122 HD patients (from 442 facilities) to determine the association between seasonally related climatic variables and CRI and septicemia. Climatic variables were determined by linkage to National Climatic Data Center of National Oceanic and Atmospheric Administration data. Catheter care protocols were examined to determine if they could mitigate infection risk during high‐risk seasons. Survival models were used to estimate the adjusted hazard ratio (AHR) of septicemia by season and by facility catheter dressing protocol. The overall catheter‐related septicemia rate was 0.47 per 1000 catheter days. It varied by season, with an AHR for summer of 1.46 (95% CI: 1.19–1.80) compared with winter. Septicemia was associated with temperature (AHR = 1.07; 95% CI: 1.02–1.13; p  < 0.001). Dressing protocols using chlorhexidine (AHR of septicemia = 0.55; 95% CI: 0.39–0.78) were associated with fewest episodes of CRI or septicemia. Higher catheter‐related septicemia in summer may be due to seasonal conditions (e.g., heat, perspiration) that facilitate bacterial growth and compromise protective measures. Extra vigilance and use of chlorhexidine‐based dressing protocols may provide prophylaxis against CRI and septicemia.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102686/1/sdi12141.pd

A novel pH-sensitive liposome formulation containing oleyl alcohol

AbstractpH-sensitive liposomes are designed to undergo acid-triggered destabilization. First generation pH-sensitive liposomes, based on the cone-shaped lipid dioleoylphosphatidylethanolamine (DOPE), have been shown to lose fusogenicity in the presence of serum. Here, we report the design and evaluation of novel serum-resistant pH-sensitive liposome formulations that are based on the composition of egg phosphatidylcholine (PC), cholesteryl hemisuccinate (CHEMS), oleyl alcohol (OAlc), and Tween-80 (T-80). When loaded with the fluorescent probe calcein, these liposomes exhibited excellent stability at pH 7.4 and underwent rapid destabilization upon acidification as shown by calcein dequenching and particle size increase. Adjusting the mole percentages of T-80 and OAlc in the formulation could regulate the stability and pH-sensitive properties of these liposomes. Liposomes with a higher T-80 content exhibited greater stability but were less sensitive to acid-induced destabilization. Meanwhile, formulations with a higher OAlc content exhibited greater content release in response to low pH. The pH-triggered liposomal destabilization did not produce membrane fusion according to an octadecylrhodamine B chloride (R18) lipid-mixing assay. Compared to DOPE-based pH-sensitive liposomes, the above formulations showed much better retention of their pH-sensitive properties in the presence of 10% serum. These liposomes were then evaluated for intracellular delivery of entrapped cytosine-β-d-arabinofuranoside (araC) in KB human oral cancer cells, which have elevated folate receptor (FR) expression. The FR, which is amplified in many types of human tumors, has been shown to mediate the internalization of folate-derivatized liposomes into an acidic intracellular compartment. FR-targeted OAlc-based pH-sensitive liposomes, entrapping 200 mM araC, showed ∼17-times greater FR-dependent cytotoxicity in KB cells compared to araC delivered via FR-targeted non-pH-sensitive liposomes. These data indicated that pH-sensitive liposomes based on OAlc, combined with FR-mediated targeting, are promising delivery vehicles for membrane impermeable therapeutic agents

Stability assessment and improvement of MTDC system connected with offshore wind farms

This paper focuses on the assessment and improvement of the DC network stability of multi-terminal HVDC (MTDC) systems based on Modular Multilevel Converters (MMCs). Therefore, the DC terminal small-signal impedance models for MMCs with different controllers and AC side connections, including onshore AC networks and offshore wind farms (OWFs), are developed in this study. These models are based on the harmonic state space (HSS) method, which accurately captures the internal multi-harmonic couplings of the MMC. Further, by utilizing the impedance models, the paper investigates the effects of different active power controllers and DC cable distances between OWFs, and different DC cable technologies including Cross-linked polyethylene (XLPE) and High-Temperature Superconducting (HTS) cables on the stability of the DC network. To address the negative damping observed in the DC impedance of the MMCs, an improved damping controller implemented with the MMC circulating current controller is proposed to counteract the destabilizing effects and enhance the stability of the DC network. The time-domain simulation results demonstrate the accuracy of the DC impedance models and confirm the effectiveness of the proposed measures for improving system stability