Analyzing Reporting of Hospital Acquired Pressure Injuries in the Acute Care Setting

This project was conducted at a level one trauma center, acute care hospital consisting of 459 beds. With more patients than wound care nurses, hospital-acquired pressure injuries (HAPIs) have become a significant problem for this hospital. A gap between reporting in the Safety and Quality Information System (SQIS) and the reporting that takes place in electronic health record (EHR) with wound care consults has been observed. A root cause analysis (RCA) was used to identify discrepancies. The accurate collection of data was identified as paramount providing information necessary to create improvements and lower the occurrence of HAPIs. The conceptual framework which guided this project to decrease the incidence of inaccurate HAPI documentation was the PDSA model/cycle. The Lewin Change Model was applied as the leadership theory. The cost of one HAPI is $14,506 and can potentially cost the hospital$2,088,864 per year. With the proper education to prevent HAPIs from occurring, the medical center can save on average $1,044,432 per year. The plan is to educate nurses on the prevention, correct staging, and proper documentation of HAPIs. Using process and balance measures, the team can study the effectiveness of the interventions. Additionally, nurses who attended educational sessions completed pre and post tests to assess their knowledge which was then compared through a bar chart. With all these efforts, expected outcomes are to sustain a 50% decrease in HAPIs at this hospital

Effect of freshwater discharge from Namgang Dam on ichthyoplankton assemblage structure in Jinju Bay, Korea

The movement of fish eggs and larvae in bay and estuarine systems is affected by freshwater discharge. In this study, the assemblage structures of ichthyoplankton eggs and larvae were assessed for the first time in Jinju Bay, South Korea, to identify the spawning and nursery functions of the bay. Fish eggs and larvae and several environmental parameters were sampled monthly from April 2015 to March 2016 inside and outside of the bay. Within the bay we collected eggs and larvae from 25 and 35 species, respectively, indicating greater diversity than outside the bay, where we collected eggs and larvae of 20 and 28 species, respectively. Fluctuations in water temperature and salinity were larger inside than outside of the bay, and chlorophyll-a concentration was higher within the bay, likely due to discharge from the Namgang Dam, which causes water to flow from the inside to the outside of the bay. This process influences fish larva abundance, such that more larvae are found outside than inside the bay. We also found that 28 fish species use Jinju Bay as a spawning ground. For some species, the timing of egg and larva appearance differed inside and outside of the bay, suggesting that the timing of spawning may differ between the two environments

Effective Long-Distance Pollen Dispersal in Centaurea jacea

BACKGROUND: Agri-environment schemes play an increasingly important role for the conservation of rare plants in intensively managed agricultural landscapes. However, little is known about their effects on gene flow via pollen dispersal between populations of these species. METHODOLOGY/PRINCIPAL FINDINGS: In a 2-year experiment, we observed effective pollen dispersal from source populations of Centaurea jacea in restored meadows, the most widespread Swiss agri-environment scheme, to potted plants in adjacent intensively managed meadows without other individuals of this species. Potted plants were put in replicated source populations at 25, 50, 100 m and where possible 200 m distance from these source populations. Pollen transfer among isolated plants was prevented by temporary bagging, such that only one isolated plant was accessible for flower visitors at any one time. Because C. jacea is self-incompatible, seed set in single-plant isolates indicated insect mediated effective pollen dispersal from the source population. Seed set was higher in source populations (35.7+/-4.4) than in isolates (4.8+/-1.0). Seed set declined from 18.9% of that in source populations at a distance of 25 m to 7.4% at 200 m. At a distance of 200 m seed set was still significantly higher in selfed plants, indicating long-distance effective pollen dispersal up to 200 m. Analyses of covariance suggested that bees contributed more than flies to this long-distance pollen dispersal. We found evidence that pollen dispersal to single-plant isolates was positively affected by the diversity and flower abundance of neighboring plant species in the intensively managed meadow. Furthermore, the decline of the dispersal was less steep when the source population of C. jacea was large. CONCLUSIONS: We conclude that insect pollinators can effectively transfer pollen from source populations of C. jacea over at least 200 m, even when "recipient populations" consisted of single-plant isolates, suggesting that gene flow by pollen over this distance is very likely. Source population size and flowering environment surrounding recipient plants appear to be important factors affecting pollen dispersal in C. jacea. It is conceivable that most insect-pollinated plants in a network of restored sites within intensively managed grassland can form metapopulations, if distances between sites are of similar magnitude as tested here

Identification of Genetic Factors that Modify Clinical Onset of Huntington’s Disease

SummaryAs a Mendelian neurodegenerative disorder, the genetic risk of Huntington’s disease (HD) is conferred entirely by an HTT CAG repeat expansion whose length is the primary determinant of the rate of pathogenesis leading to disease onset. To investigate the pathogenic process that precedes disease, we used genome-wide association (GWA) analysis to identify loci harboring genetic variations that alter the age at neurological onset of HD. A chromosome 15 locus displays two independent effects that accelerate or delay onset by 6.1 years and 1.4 years, respectively, whereas a chromosome 8 locus hastens onset by 1.6 years. Association at MLH1 and pathway analysis of the full GWA results support a role for DNA handling and repair mechanisms in altering the course of HD. Our findings demonstrate that HD disease modification in humans occurs in nature and offer a genetic route to identifying in-human validated therapeutic targets in this and other Mendelian disorders.PaperCli

Rare Decays of the η′\eta^{'}

We have searched for the rare decays of the eta prime meson to e+ e- eta, e+ e- pizero, e+ e- gamma, and e mu in hadronic events at the CLEO II detector. The search is conducted on 4.80 fb^-1 of e+ e- collisions at the Cornell Electron Storage Ring. We find no signal in any of these modes, and set 90% confidence level upper limits on their branching fractions of 2.4 X 10^-3, 1.4 X 10^-3, 0.9 X 10^-3, and 4.7 X 10^-4, respectively. We also investigate the Dalitz plot of the common decay of the eta prime to pi+ pi- eta. We fit the matrix element with the Particle Data Group parameterization and find Re(alpha) = -0.021 +- 0.025, where alpha is a linear function of the kinetic energy of the eta.Comment: 12 pages postscript, also available through http://w4.lns.cornell.edu/public/CLN

UV Irradiation Induces a Non-coding RNA that Functionally Opposes the Protein Encoded by the Same Gene

The transcription-related DNA damage response was analyzed on a genome-wide scale with great spatial and temporal resolution. Upon UV irradiation, a slowdown of transcript elongation and restriction of gene activity to the promoter-proximal ∼25 kb is observed. This is associated with a shift from expression of long mRNAs to shorter isoforms, incorporating alternative last exons (ALEs) that are more proximal to the transcription start site. Notably, this includes a shift from a protein-coding ASCC3 mRNA to a shorter ALE isoform of which the RNA, rather than an encoded protein, is critical for the eventual recovery of transcription. The non-coding ASCC3 isoform counteracts the function of the protein-coding isoform, indicating crosstalk between them. Thus, the ASCC3 gene expresses both coding and non-coding transcript isoforms with opposite effects on transcription recovery after UV-induced DNA damage

CAG repeat not polyglutamine length determines timing of Huntington’s disease onset

Variable, glutamine-encoding, CAA interruptions indicate that a property of the uninterrupted HTT CAG repeat sequence, distinct from the length of huntingtin’s polyglutamine segment, dictates the rate at which Huntington’s disease (HD) develops. The timing of onset shows no significant association with HTT cis-eQTLs but is influenced, sometimes in a sex-specific manner, by polymorphic variation at multiple DNA maintenance genes, suggesting that the special onset-determining property of the uninterrupted CAG repeat is a propensity for length instability that leads to its somatic expansion. Additional naturally occurring genetic modifier loci, defined by GWAS, may influence HD pathogenesis through other mechanisms. These findings have profound implications for the pathogenesis of HD and other repeat diseases and question the fundamental premise that polyglutamine length determines the rate of pathogenesis in the “polyglutamine disorders.

Modelling of the effect of ELMs on fuel retention at the bulk W divertor of JET

Effect of ELMs on fuel retention at the bulk W target of JET ITER-Like Wall was studied with multi-scale calculations. Plasma input parameters were taken from ELMy H-mode plasma experiment. The energetic intra-ELM fuel particles get implanted and create near-surface defects up to depths of few tens of nm, which act as the main fuel trapping sites during ELMs. Clustering of implantation-induced vacancies were found to take place. The incoming flux of inter-ELM plasma particles increases the different filling levels of trapped fuel in defects. The temperature increase of the W target during the pulse increases the fuel detrapping rate. The inter-ELM fuel particle flux refills the partially emptied trapping sites and fills new sites. This leads to a competing effect on the retention and release rates of the implanted particles. At high temperatures the main retention appeared in larger vacancy clusters due to increased clustering rate