224 research outputs found

    Negotiating Practicum Experiences in a Reading Specialist Preparation Program

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    In this cross-case study, we examined how two reading specialist candidates negotiated their yearlong practicum experiences in relation to university coursework and their previous teaching experience. Data sources included interviews, weekly teaching logs, and field observations. Findings reported in extended vignettes reveal how both interns were placed in positions that required them to negotiate instructional expectations at their internship sites and practices advocated in their coursework. In both cases, those two realities were often at odds when they were required to implement a program with scripted lessons and a required pacing guide. The findings raise important questions about the impact of such experiences on reading specialist preparation and representation of the reading specialist role

    Cytomegalovirus protein m154 perturbs the adaptor protein-1 compartment mediating broad-spectrum immune evasion

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    Cytomegaloviruses (CMVs) are ubiquitous pathogens known to employ numerous immunoevasive strategies that significantly impair the ability of the immune system to eliminate the infected cells. Here, we report that the single mouse CMV (MCMV) protein, m154, downregulates multiple surface molecules involved in the activation and costimulation of the immune cells. We demonstrate that m154 uses its cytoplasmic tail motif, DD, to interfere with the adaptor protein-1 (AP-1) complex, implicated in intracellular protein sorting and packaging. As a consequence of the perturbed AP-1 sorting, m154 promotes lysosomal degradation of several proteins involved in T cell costimulation, thus impairing virus-specific CD8+ T cell response and virus control in vivo. Additionally, we show that HCMV infection similarly interferes with the AP-1 complex. Altogether, we identify the robust mechanism employed by single viral immunomodulatory protein targeting a broad spectrum of cell surface molecules involved in the antiviral immune response

    Antibiotics and antiseptics for pressure ulcers

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    Background: Pressure ulcers, also known as bedsores, decubitus ulcers and pressure injuries, are localised areas of injury to the skin or the underlying tissue, or both. A range of treatments with antimicrobial properties, including impregnated dressings, are widely used in the treatment of pressure ulcers. A clear and current overview is required to facilitate decision making regarding use of antiseptic or antibiotic therapies in the treatment of pressure ulcers. This review is one of a suite of Cochrane reviews investigating the use of antiseptics and antibiotics in different types of wounds. It also forms part of a suite of reviews investigating the use of different types of dressings and topical treatments in the treatment of pressure ulcers. Objectives: To assess the effects of systemic and topical antibiotics, and topical antiseptics on the healing of infected and uninfected pressure ulcers being treated in any clinical setting. Search methods: In October 2015 we searched: the Cochrane Wounds Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), Ovid MEDLINE, Ovid MEDLINE (In-Process & Other Non-Indexed Citations), Ovid EMBASE, and EBSCOCINAHL Plus.We also searched three clinical trials registries and the references of included studies and relevant systematic reviews. There were no restrictions based on language or date of publication or study setting. Selection criteria: Randomised controlled trials which enrolled adults with pressure ulcers of stage II or above were included in the review. Data collection and analysis: Two review authors independently performed study selection, risk of bias assessment and data extraction. Main results: We included 12 trials (576 participants); 11 had two arms and one had three arms. All assessed topical agents, none looked at systemic antibiotics. The included trials assessed the following antimicrobial agents: povidone iodine, cadexomer iodine, gentian violet, lysozyme, silver dressings, honey, pine resin, polyhexanide, silver sulfadiazine, and nitrofurazone with ethoxy-diaminoacridine. Comparators included a range of other dressings and ointments without antimicrobial properties and alternative antimicrobials. Each comparison had only one trial, participant numbers were low and follow-up times short. The evidence varied from moderate to very low quality. Six trials reported the primary outcome of wound healing. All except one compared an antiseptic with a non-antimicrobial comparator. There was some moderate and low quality evidence that fewer ulcers may heal in the short term when treated with povidone iodine compared with non-antimicrobial alternatives (protease-modulating dressings (risk ratio (RR) 0.78, 95% confidence interval (CI) 0.62 to 0.98) and hydrogel (RR 0.64, 95%CI 0.43 to 0.97)); and no clear difference between povidone iodine and a third non-antimicrobial treatment (hydrocolloid) (low quality evidence). Pine resin salve may heal more pressure ulcers than hydrocolloid (RR 2.83, 95% CI 1.14 to 7.05) (low quality evidence). There is no clear difference between cadexomer iodine and standard care, and between honey a combined antiseptic and antibiotic treatment (very low quality evidence). Six trials reported adverse events (primary safety outcome). Four reported no adverse events; there was very low quality evidence from one showing no clear evidence of a difference between cadexomer iodine and standard care; in one trial it was not clear whether data were appropriately reported. There was limited reporting of secondary outcomes. The five trials that reported change in wound size as a continuous outcome did not report any clear evidence favouring any particular antiseptic/anti-microbial treatments. For bacterial resistance, one trial found some evidence of more MRSA eradication in participants with ulcer treated with a polyhexanide dressing compared with a polyhexanideswab (RR 1.48, 95% CI 1.02 to 2.13); patients in the dressing group also reported less pain (MD −2.03, 95% CI −2.66 to −1.40). There was no clear evidence of a difference between interventions in infection resolution in three other comparisons. Evidence for secondary outcomes varied from moderate to very low quality; where no GRADE assessment was possible we identified substantial limitations which an assessment would have taken into account. Authors’ conclusions: The relative effects of systemic and topical antimicrobial treatments on pressure ulcers are not clear. Where differences in wound healing were found, these sometimes favoured the comparator treatment without antimicrobial properties. The trials are small, clinically heterogenous, generally of short duration, and at high or unclear risk of bias. The quality of the evidence ranges from moderate to very low; evidence on all comparisons was subject to some limitations

    Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

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    Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

    The importance of student run consulting firms :creating a consulting firm on campus

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    Consulting is a big business which involves intellectual capital and emotional intelligence. Many business students look to this industry as a career to maximize the return on their business education. Student-led consulting groups have prospered as a means to help students bridge the gap between learning tools to developing skills. This paper analyzes student-led consulting in three steps. A description of consulting, an exploration of experiential learning, and an explanation connecting the two all provide support for the last section: a plan for implementing a student-led consulting group on campus.Thesis (B.?)Honors Colleg

    Optimization of sample preparation using microwave digestion for the determination of multi-elemental composition in insect samples with ICP-MS

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    V okviru diplomskega dela je bila optimizirana metoda priprave vzorcev insektov z mikrovalovnim razkrojem za dolocitev vecelementne sestave z ICP-MS. Uporabljena sta bila dva vzorca insektov in sicer licinke mokarja (Tenebrio molitor) in hišni cricek (Acheta domesticus), ter trije standardni referencni materiali: SRM Oyster Tissue-1566b (tkivo ostrige), SRM Typical Diet-1548a (mešanica živil) in SRM Mussel Tissue 2976 (tkivo klapavice), vendar slednji ni bil upoštevan pri analizi podatkov. Optimizacija priprave vzorca je bila izvedena na podlagi spreminjanja mas vzorcev in SRM-jev, ter spreminjanja volumnov razlicnih reagentov za razkroj. Preverjene so bile tri razlicne mase materiala: 0,1 g0,2 g0,4 g. Volumni reagentov so se spreminjali sledece: HNO3 (67 %-69 %): 1 mL2 mL4 mL, H2O2 (30 %): 0 mL0,25 mL0,5 mL1 mL in HF (40 %): 0 µL10 µL20 µL30 µL. S kombinacijami navedenih parametrov je bilo nato sestavljenih devet razlicnih metod priprave vzorca, ki je bil vsakic razkrojen z mikrovalovnim sistemom z nastavljenim programom: 20 min narašcanje temperature do 240 °C, razkroj 15 min pri 240 °C in 100 barov in 30 min ohlajanja in nižanja tlaka. Razkrojenim raztopinam so bile nato z ICP-MS tehniko pomerjene koncentracije sledecih elementov: natrij, kalcij, kalij, magnezij, železo, cink, aluminij, vanadij, krom, mangan, nikelj, baker, kobalt, arzen, selen, srebro, kadmij in svinec. Umeritvene krivulje so bile pripravljene s standardnimi raztopinami teh elementov v sledecih koncentracijskih obmocjih: 00,050,1000,5001,005,0010,050,0 in 100 ng/mL za prvih sedem navedenih elementov, oziroma: 01,005,0010,0050,01005001000 in 2000 ng/mL za ostale elemente. Rezultati so bili potem statisticno obdelani. Izracunani in zbrani v preglednici so bili povprecni izkoristki za oba standardna referencna materiala, narejene so bile kontrolne karte za dolocene elemente in izracunani so bili relativni standardni odmiki, ter njihovo povprecje masnih deležev elementov v vzorcih. Na podlagi najboljših izkoristkov in najmanjših relativnih standardnih odmikov je bila nato dolocena najoptimalnejša od devetih metod mikrovalovnega razkroja vzorca. To je bila metoda, pri kateri smo uporabili 0,1 g vzorca ali referencnega materiala, 1 mL HNO3 in 0,25 mL H2O2.In the making of the thesis, the method of preparation of insect samples with microwave digestion was optimized for the determination of multi-elemental composition with ICP-MS. Two insect samples were used, i.e., the mealworm larvae (Tenebrio molitor) and the house cricket (Acheta domesticus). Besides that, three standard reference materials were used: SRM Oyster Tissue-1566b, SRM Typical Diet-1548a and SRM Mussel Tissue 2976, however tha latter was not included in the data processing. Optimization of the sample preparation was caried out on the basis of changing the masses of samples and standard referance materials and volumes of different reagents for decomposition. Three different masses of material were tested: 0,1 g0,2 g0,4 g. The volumes of the reagents varied as follows: HNO3 (67 %-69 %): 1 mL2 mL4 mL, H2O2 (30 %): 0 mL0,25 mL0,5 mL1 mL and HF (40 %): 0 µL10 µL20 µL30 µL. Using a combination of these parameters, nine different methods of sample preparation were than constructed. Each time samples were digested using a microwave digestion system with a set program: 20 min temperature rise to 240 °C, digestion for 15 min at 240 °C and 100 bar and 30 min cooling and pressure reduction. The concentrations of the following elements were then measured in the digested solutions using ICP-MS technique: sodium, calcium, potassium, magnesium, iron, zinc, aluminum, vanadium, chromium, manganese, nickel, copper, cobalt, arsenic, selenium, silver, cadmium and lead. Calibration curves were prepared with standard solutions of these elements in the following concentration ranges: 00,050,1000,5001,005,0010,050,0 in 100 ng/mL for the first seven listed elements and: 01,005,0010,0050,01005001000 in 2000 ng/mL for other elements. The results were than statisticly processed. Average recoveries for the two standard referance materials were than calculated and control charts for selected elements were created. Furthermore, relative standard deviations and their averages were calculated for concentrations of elements in both samples. Based on the best recoveries and smallest relative standard deviations, the most optimal of the nine methods of sample preparation for microwave digestion was then determined. That was a method that used 0,1 g of sample or standard referance material, 1 mL of HNO3 and 0,25 mL of H2O2
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