St. Louis Regional Greenhouse Gas Reduction Strategy

This semester the Greenhouse Gas Reduction Team (GHGRT) of the Sustainability Exchange program at Washington University in St. Louis was tasked with initial planning to decrease greenhouse gas emissions in the St. Louis area for OneSTL. To do so, GHGRT began by meeting with experts in the field, including Rene Dulle, Tim Michels, and Emily Andrews, to determine the best course of action and get insight into the situation as it stands. Based on this information, we decided to focus on building energy use and resulting carbon emissions. The team then researched energy use in the city of St. Louis and investigated Ameren’s plan for converting from fossil fuels to carbon neutral energy by 2050. The team also investigated paths for funding for St. Louis citizens through avenues such as the Inflation Reduction Act (IRA), and rebates from Spire and Ameren. The team also considered non-technical and non-monetary strategies for reducing carbon emissions, focusing on community education. To complete our analysis, we created several model scenarios for citizens and buildings in St. Louis to show how our strategies could be implemented in the real world. In this report we also discussed some challenges we had while completing the project as well as some expected future steps for this project

Thyroseq V3 Molecular Profiling for Tailoring the Surgical Management of Hürthle Cell Neoplasms.

Hürthle cell predominant thyroid nodules often confound the diagnostic utility of fine needle aspiration biopsy (FNAB) with cytology often interpreted as a Hürthle cell lesion with an indeterminate risk of malignancy, Bethesda category (BC) III or IV. Molecular diagnostics for Hürthle cell predominant nodules has also been disappointing in further defining the risk of malignancy. We present a case of a slowly enlarging nodule within a goiter initially reported as benign on FNAB, BC II but on subsequent FNAB suspicious for a Hürthle cell neoplasm, BC IV. The patient had initially requested a diagnostic lobectomy for a definitive diagnosis despite a higher risk of malignancy based on the size of the nodule \u3e 4 cm alone. To better tailor this patient\u27s treatment plan, a newer expanded gene mutation panel, ThyroSeq® v3 that includes copy number alterations (CNAs) and was recently found to have greater positive predictive value (PPV) for identifying Hürthle cell carcinoma (HCC), was performed on the FNAB material. Molecular profiling with ThyroSeq® v3 was able to predict a greater risk of carcinoma, making a more convincing argument in favor of total thyroidectomy. Surgical pathology confirmed a Hürthle cell carcinoma with 5 foci of angioinvasion and foci of capsular invasion

Prevalence and age-of-onset distributions of DSM IV mental disorders and their severity among school going Omani adolescents and youths: WMH-CIDI findings

<p>Abstract</p> <p>Background</p> <p>There is a dearth of studies exploring the magnitude of mental disorders amongst adolescents and youths in the Arab world. To our knowledge, this phase 2 survey in Oman is the first nationally representative school-based study to determine the prevalence of DSM-IV mental disorders (lifetime and over the preceding 12 months), their age-of-onset distributions and determine their severity over the past 12 months using the World Mental Health-Composite International Diagnostic Interview, the WMH-CIDI, used for international comparison.</p> <p>Methods</p> <p>A total of 1,682 (91.61%) students out of 1836 students who formed the phase 2 random sub-sample of a multi-stage, stratified, random sampling design (phase 1), participated in the face-to-face structured interview using the Arabic-version of WMH-CIDI 3.0.</p> <p>Results</p> <p>The phase 1 results using the General Health Questionnaire (GHQ-12) and Child Depression Inventory (CDI) showed depressive symptoms to be 17% prevalent in the larger sample of 5409 adolescents and youths. Amongst the phase 2 respondents from this sample, 13.9% had at least one DSM IV diagnostic label. The lifetime prevalence of Major Depressive Disorder (MDD) was 3.0%; Bipolar Mood Disorder (BMD) was 1%, Specific phobia 5.8% and Social phobia 1.6%. The female gender was a strong predictor of a lifetime risk of MDD (OR 3.3, 95% CI 1.7-6.3, <it>p </it>= 0.000); Any Mood Disorders (OR 2.5, 95% CI 1.4-4.3, p = 0.002) and Specific Phobia (OR 1.5, 95% CI 1.0-2.4, p = 0.047). The severity of illness for cases diagnosed with 12 month DSM IV disorders was found to be 80% lower in females (OR 0.2, 95%CI 0.0-0.8). The estimates over the previous 12 month period when compared with the lifetime prevalence showed a 25% to 40% lower prevalence for MDD, Specific phobia, Social phobia, Any Anxiety Disorders (AAD) and Any Mood disorders (AMD) while the rate was 80% lower for Separation Anxiety Disorder/Adult Separation Anxiety (SAD/ASA). Mood disorders were significantly lower in the 14-16 age groups (70% lower) in comparison to the older age groups and AMD showed a linear increase in prevalence across increasing age groups (<it>p </it>= 0.035).</p> <p>Conclusion</p> <p>The implications of the present findings are not clear cut, however this study endorses the adult CIDI studies findings that mental disorders do begin earlier in life. The relatively lower prevalence of DSM IV depressive disorders cautions against any conclusive interpretation of the inflated results based on the exclusive study of the depressive symptoms alone in the same sample in the same time period. The female gender proved to be a strong predictor of lifetime risk of MDD, any mood disorder and specific phobia. Under-reporting by males or some other gender-specific factors may have contributed to such a discrepancy. The odds of the severity of illness for cases with 12 month DSM IV disorders were significantly lower in females.</p

Synergy Realization as a Framework for Defining and Measuring Higher Education Merger Success

Over the last several decades, significant pressures resulting from financial challenges, declining undergraduate enrollments, changing demographics and now the COVID-19 pandemic, have caused college and university leaders to consider interinstitutional merger for both economic and strategic purposes. However, both knowledge and methodological gaps in the literature leave higher education leaders without frameworks or evidence with which to make decisions or take action in a challenging landscape. Specifically, there is little agreement about the definition of success beyond avoidance of closure. Employing a single case study design, I explored how senior and mid-level staff and faculty members made sense of the 2017 merger between Philadelphia University (PhilaU) and Thomas Jefferson University (TJU) and how they conceptualized and measured its success. Further, I examined the extent to which Feldman and Hernandez’s (2021) corporate synergy realization framework might be applied to guide future decision-making, action and evaluation relative to value creation in higher education mergers. Methods included 26 interviews, archival documents, direct observations, and member checks. My findings have implications for administrators and board members for practice, theory development and future research. Institutional leaders generated significant buy-in for the Jefferson merger as an opportunity to create innovative, transdisciplinary education marrying medicine and design. However, while dissimilarities in mission and expertise helped generate important synergies, they also led to vast cultural differences presenting ongoing challenges. Despite buy-in resulting from an inclusive pre-planning endeavor, the integration process was painful, particularly for those originally from PhilaU, a much smaller and less well-resourced legacy institution. Technology, human resources and faculty affairs integration have been especially difficult and painful. The synergy realization framework is a promising tool for evaluating higher education merger success in a standardized manner. All five synergy types—internal, market power, relational, network and non-market—were identified in the Jefferson combination, along with co- and dis-synergies, which enhance or reduce the value of others. The synergy lifecycle introduced by Feldman and Hernandez (2021) adds nuance to the idea of value creation. Further research will add additional depth and breadth to these findings, helping to guide higher education practice and enhance merger theory