The Effects of Simulation with Cooperative Learning Strategies in a College Sonography Lab

This action research study investigated adding a combination of learning strategies to a sonography lab course and its impact on student performance. The study was conducted in a junior college level sonography lab with 20 female participants between the ages of 20 to 29. The duration of the study was six weeks. Both qualitative and quantitative data tools were utilized. A pre- and post-survey, instructor lab journals, peer review exercises, quizzes, and competencies scores were used to measure effectiveness. The findings indicated an increase in sonography competency scores when compared to the previous year and an increase in the students’ perceived value of the various strategies. The addition of simulation, rehearsal, and peer review exercises yielded positive results. The implications for results, study limitations and further research are discussed

Rapid, Precise, and High-Sensitivity Acquisition of Paleomagnetic and Rock-Magnetic Data: Development of a Low-Noise Automatic Sample Changing System for Superconducting Rock Magnetometers

Among Earth sciences, paleomagnetism is particularly linked to the statistics of large sample sets as a matter of historical development and logistical necessity. Because the geomagnetic field varies over timescales relevant to sedimentary deposition and igneous intrusion, while the fidelity of recorded magnetization is modulated by original properties of rock units and by alteration histories, "ideal" paleomagnetic results measure remanent magnetizations of hundreds of samples at dozens of progressive demagnetization levels, accompanied by tests of magnetic composition on representative sister specimens. We present an inexpensive, open source system for automating paleomagnetic and rock magnetic measurements. Using vacuum pick-and-place technology and a quartz-glass sample holder, the system can in one hour measure remanent magnetizations, as weak as a few pAm2, of ~30 specimens in two vertical orientations with measurement errors comparable to those of the best manual systems. The system reduces the number of manual manipulations required per specimen ~8 fold

Not All Children with Cystic Fibrosis Have Abnormal Esophageal Neutralization during Chemical Clearance of Acid Reflux.

PurposeAcid neutralization during chemical clearance is significantly prolonged in children with cystic fibrosis, compared to symptomatic children without cystic fibrosis. The absence of available reference values impeded identification of abnormal findings within individual patients with and without cystic fibrosis. The present study aimed to test the hypothesis that significantly more children with cystic fibrosis have acid neutralization durations during chemical clearance that fall outside the physiological range.MethodsPublished reference value for acid neutralization duration during chemical clearance (determined using combined impedance/pH monitoring) was used to assess esophageal acid neutralization efficiency during chemical clearance in 16 children with cystic fibrosis (3 to <18 years) and 16 age-matched children without cystic fibrosis.ResultsDuration of acid neutralization during chemical clearance exceeded the upper end of the physiological range in 9 of 16 (56.3%) children with and in 3 of 16 (18.8%) children without cystic fibrosis (p=0.0412). The likelihood ratio for duration indicated that children with cystic fibrosis are 2.1-times more likely to have abnormal acid neutralization during chemical clearance, and children with abnormal acid neutralization during chemical clearance are 1.5-times more likely to have cystic fibrosis.ConclusionSignificantly more (but not all) children with cystic fibrosis have abnormally prolonged esophageal clearance of acid. Children with cystic fibrosis are more likely to have abnormal acid neutralization during chemical clearance. Additional studies involving larger sample sizes are needed to address the importance of genotype, esophageal motility, composition and volume of saliva, and gastric acidity on acid neutralization efficiency in cystic fibrosis children

Late Holocene sea- and land-level change on the U.S. southeastern Atlantic coast

Late Holocene relative sea-level (RSL) reconstructions can be used to estimate rates of land-level (subsidence or uplift) change and therefore to modify global sea-level projections for regional conditions. These reconstructions also provide the long-term benchmark against which modern trends are compared and an opportunity to understand the response of sea level to past climate variability. To address a spatial absence of late Holocene data in Florida and Georgia, we reconstructed ~ 1.3 m of RSL rise in northeastern Florida (USA) during the past ~ 2600 years using plant remains and foraminifera in a dated core of high salt-marsh sediment. The reconstruction was fused with tide-gauge data from nearby Fernandina Beach, which measured 1.91 ± 0.26 mm/year of RSL rise since 1900 CE. The average rate of RSL rise prior to 1800 CE was 0.41 ± 0.08 mm/year. Assuming negligible change in global mean sea level from meltwater input/removal and thermal expansion/contraction, this sea-level history approximates net land-level (subsidence and geoid) change, principally from glacio-isostatic adjustment. Historic rates of rise commenced at 1850–1890 CE and it is virtually certain (P = 0.99) that the average rate of 20th century RSL rise in northeastern Florida was faster than during any of the preceding 26 centuries. The linearity of RSL rise in Florida is in contrast to the variability reconstructed at sites further north on the U.S. Atlantic coast and may suggest a role for ocean dynamic effects in explaining these more variable RSL reconstructions. Comparison of the difference between reconstructed rates of late Holocene RSL rise and historic trends measured by tide gauges indicates that 20th century sea-level trends along the U.S. Atlantic coast were not dominated by the characteristic spatial fingerprint of melting of the Greenland Ice Sheet

Gastroesophageal reflux in cystic fibrosis across the age spectrum.

Background:Scientific advances have improved longevity in cystic fibrosis (CF) patients and many of these patients can expect to experience age-related gastrointestinal co-morbidities. We aimed to assess the extent to which age might impact gastroesophageal reflux (GER) in patients with CF. Methods:Our esophageal pH-multichannel intraluminal impedance monitoring database was searched for tracings belonging to CF patients ≥2 years old without prior fundoplication and not taking anti-reflux medications immediately prior (within 7 days) and during the study. Tracings were retrospectively analyzed; Impedance and pH variables were evaluated with respect to age and pulmonary function. Results:Twenty-eight patients were enrolled; 16 children (3.1-17.7 years) and 12 adults (18.2-48.9 years). Among pH probe parameters, correlation analysis showed DeMeester score (P=0.011) and number of acid reflux events lasting >5 minutes (P=0.047) to be significantly correlated with age. Age was not significantly correlated with any of the impedance parameters. Age was negatively correlated with baseline impedance (BI) in the distal esophagus (r=-0.424, P=0.023) and BI was negatively correlated with several pH parameters, including reflux index (r=-0.553, P=0.002), number of total acid reflux events (r=-0.576, P=0.001), number of acid reflux events lasting >5 minutes (r=-0.534, P=0.003), and DeMeester score (r=-0.510, P=0.006). Pulmonary function (percent predicted forced expiratory volume in one minute; ppFEV1) was negatively correlated with age (r=-0.494, P=0.0007). The interaction of age and ppFEV1 and any of the reflux parameters, however, was not significant (P>0.05); the strongest evidence for an interaction was found for the number of acid reflux events reaching the proximal esophagus, but this interaction still did not reach statistical significance (P=0.070). Conclusions:In a small cohort, we found evidence that age may be associated with increased acid exposure and that both age and increased acid exposure are associated with reduced BI in the distal esophagus. The negative relationship between pulmonary function and age in our cohort is not related to GER. This pilot study supports the need for esophageal assessment and treatment of GER as standard components of clinical care for an aging CF population

Experimental warming differentially affects vegetative and reproductive phenology of tundra plants

Rapid climate warming is altering Arctic and alpine tundra ecosystem structure and function, including shifts in plant phenology. While the advancement of green up and flowering are well-documented, it remains unclear whether all phenophases, particularly those later in the season, will shift in unison or respond divergently to warming. Here, we present the largest synthesis to our knowledge of experimental warming effects on tundra plant phenology from the International Tundra Experiment. We examine the effect of warming on a suite of season-wide plant phenophases. Results challenge the expectation that all phenophases will advance in unison to warming. Instead, we find that experimental warming caused: (1) larger phenological shifts in reproductive versus vegetative phenophases and (2) advanced reproductive phenophases and green up but delayed leaf senescence which translated to a lengthening of the growing season by approximately 3%. Patterns were consistent across sites, plant species and over time. The advancement of reproductive seasons and lengthening of growing seasons may have significant consequences for trophic interactions and ecosystem function across the tundra

Vitamin D in the general population of young adults with autism in the Faroe Islands

Vitamin D deficiency has been proposed as a possible risk factor for developing autism spectrum disorder (ASD). 25-Hydroxyvitamin D3 (25(OH)D3) levels were examined in a cross-sectional population-based study in the Faroe Islands. The case group consisting of a total population cohort of 40 individuals with ASD (aged 15–24 years) had significantly lower 25(OH)D3 than their 62 typically-developing siblings and their 77 parents, and also significantly lower than 40 healthy age and gender matched comparisons. There was a trend for males having lower 25(OH)D3 than females. Effects of age, month/season of birth, IQ, various subcategories of ASD and Autism Diagnostic Observation Schedule score were also investigated, however, no association was found. The very low 25(OH)D3 in the ASD group suggests some underlying pathogenic mechanism

Renal Denervation Update From the International Sympathetic Nervous System Summit:JACC State-of-the-Art Review

Three recent renal denervation studies in both drug-naïve and drug-treated hypertensive patients demonstrated a significant reduction of ambulatory blood pressure compared with respective sham control groups. Improved trial design, selection of relevant patient cohorts, and optimized interventional procedures have likely contributed to these positive findings. However, substantial variability in the blood pressure response to renal denervation can still be observed and remains a challenging and important problem. The International Sympathetic Nervous System Summit was convened to bring together experts in both experimental and clinical medicine to discuss the current evidence base, novel developments in our understanding of neural interplay, procedural aspects, monitoring of technical success, and others. Identification of relevant trends in the field and initiation of tailored and combined experimental and clinical research efforts will help to address remaining questions and provide much-needed evidence to guide clinical use of renal denervation for hypertension treatment and other potential indications