How Perioperative Clinics at Duke University Can be Utilized to Narrow the Gap of Health Disparities in African American Populations: A Narrative Review

An issue often explored in today’s social climate is racial inequalities in our healthcare system and the strong negative outcomes it has on minority patient populations. This is a result of a combination of social factors not limited to, healthcare resources available to these patients, implicit bias by providers, discrimination of patient population, and a system of healthcare perpetuating continued injustices. Research has shown the operating room is no exception, but recent advances in perioperative medicine may be a key to eliminating barriers to equitable healthcare for patients of color. The purpose of this narrative review is to bring awareness to the utility of using perioperative clinics to bring equitable health care to patients of color who are historically at an increased risk of post-operative complications. Innovation of these multidisciplinary clinics is not only a huge stepping-stone in the field of anesthesia, but also an avenue to narrow the gap in health disparities amongst patients of color. Perioperative clinics utilize objective data to assess a patient’s readiness for surgery and minimize physician bias while boosting access to healthcare for disadvantaged patient populations

Applying Design-Thinking In Didactic ActivitieS (ADIDAS)

Background: Although didactic lectures are a common medical education teaching method, data suggest long term retention is minimal. Objective: Design thinking as a potential means to improve a didactic session on operating room (OR) equipment and safety is explored here. Methods: During a 2021 didactic session for five CA-1 residents, a faculty member structured a design activity on OR equipment and safety. The residents were asked to build an OR rapid prototype using office supplies. They were given ten minutes to brainstorm, followed by thirty minutes to build. Results: General feedback from residents (60% response rate) was positive, reporting increased knowledge and engagement. Conclusions: This activity required the residents to think critically about the functions of anesthesia machines from multiple perspectives, including patient safety and clinician needs. The design thinking process may help the residents better retain information, understand, and engage with the purpose of each item in the OR. Efficacy in future iterations will be through resident ITE score gaps in this topic. Future studies should ascertain the applicability of this learning format to specific didactic lectures

Utilization of Intelligent Tutoring System (ITS) in mathematics learning

Intelligent Tutoring Systems (ITS) represent some of the knowledge and reasoning of good oneto-one human tutors, and consequently are able to coach students in a more detailed way as compared to the Computer Assisted Instructions (CAI) packages. Canfield (2001) defines ITS as a system that is able to diagnose and adapt to student's knowledge and skills. According to Canfield, ITS is able to provide precise feedbacks when mistakes are made and able to present new topics when the student is ready to learn. ITS is part of a new breed of instructional computer programs. This paper discusses the benefits of using an ITS as complement to the use CAI materials such as the courseware in promoting the learning of mathematics. Benefits of using an ITS have been proven in aspects such as generating useful feedbacks to students in learning mathematic, assisting learning of higher order subject matter and cultivating higher order skills, offering a learning environment that motivates learners, giving useful instant feedback to learners, and providing positive effects on student’s achievement

Assessing a hierarchical sustainable solid waste management structure with qualitative information:policy and regulations drive social impacts and stakeholder participation

This study contributes to building a valid hierarchical sustainable solid waste management (SSWM) attribute set with qualitative information, which is a complicated and ambiguous problem with uncertainties. Few studies have provided qualitative information and have addressed the interrelationships and interdependencies among the hierarchical SSWM attributes. SSWM has recently become a difficult problem to solve due to urbanization, inequality, and economic growth. This study aims to propose an SSWM attribute set and identify a causal model through linguistic preferences by using a fuzzy decision-making trial and evaluation laboratory approach to simultaneously handle the uncertainty and the interrelationships. The analytic network process is used to develop the hierarchical structure to weigh the aspects and criteria. Qualitative information is transformed into crisp and comparable values to examine the causal relationships between attributes and confirm the consistency between the theoretical structure and industry phenomena. The results indicate that policy and regulations, stakeholder participation, and social impacts play essential roles in these causal interrelationships. Political leadership in SSWM is required to drive stakeholder participation and achieve social impacts. Population growth and migration, institutional settings, waste recycling and energy recovery, households, and private contractors are the main aspects involved in improving SSWM in Vietnam

Copy Number Variation Analysis in Single-Suture Craniosynostosis: Multiple Rare Variants Including RUNX2 Duplication in Two Cousins With Metopic Craniosynostosis

Little is known about genes that underlie isolated single-suture craniosynostosis. In this study, we hypothesize that rare copy number variants (CNV) in patients with isolated single-suture craniosynostosis contain genes important for cranial development. Using whole genome array comparative genomic hybridization (CGH), we evaluated DNA from 186 individuals with single-suture craniosynostosis for submicroscopic deletions and duplications. We identified a 1.1 Mb duplication encompassing RUNX2 in two affected cousins with metopic synostosis and hypodontia. Given that RUNX2 is required as a master switch for osteoblast differentiation and interacts with TWIST I, mutations in which also cause craniosynostosis, we conclude that the duplication in this family is pathogenic, albeit with reduced penetrance. In addition, we find that a total of 7.5% of individuals with single-suture synostosis in our series have at least one rare deletion or duplication that contains genes and that has not been previously reported in unaffected individuals. The genes within and disrupted by CNVs in this cohort are potential novel candidate genes for craniosynostosis. (C) 2010 Wiley-Liss, Inc

Distortion Estimation Through Explicit Modeling of the Refractive Surface

Precise calibration is a must for high reliance 3D computer vision algorithms. A challenging case is when the camera is behind a protective glass or transparent object: due to refraction, the image is heavily distorted; the pinhole camera model alone can not be used and a distortion correction step is required. By directly modeling the geometry of the refractive media, we build the image generation process by tracing individual light rays from the camera to a target. Comparing the generated images to their distorted - observed - counterparts, we estimate the geometry parameters of the refractive surface via model inversion by employing an RBF neural network. We present an image collection methodology that produces data suited for finding the distortion parameters and test our algorithm on synthetic and real-world data. We analyze the results of the algorithm.Comment: Accepted to ICANN 201

Rudimentary G-Quadruplex-Based Telomere Capping In Saccharomyces Cerevisiae

Telomere capping conceals chromosome ends from exonucleases and checkpoints, but the full range of capping mechanisms is not well defined. Telomeres have the potential to form G-quadruplex (G4) DNA, although evidence for telomere G4 DNA function in vivo is limited. In budding yeast, capping requires the Cdc13 protein and is lost at nonpermissive temperatures in cdc13-1 mutants. Here, we use several independent G4 DNA-stabilizing treatments to suppress cdc13-1 capping defects. These include overexpression of three different G4 DNA binding proteins, loss of the G4 DNA unwinding helicase Sgs1, or treatment with small molecule G4 DNA ligands. In vitro, we show that protein-bound G4 DNA at a 3\u27 overhang inhibits 5\u27-\u3e 3\u27 resection of a paired strand by exonuclease I. These findings demonstrate that, at least in the absence of full natural capping, G4 DNA can play a positive role at telomeres in vivo

Mutations in a member of the ADAMTS gene family cause thrombotic thrombocytopenic purpura

Thrombotic thrombocytopenic purpura (TTP) is a life-threatening systemic illness of abrupt onset and unknown cause. Proteolysis of the blood-clotting protein von Willebrand factor (VWF) observed in normal plasma is decreased in TTP patients. However, the identity of the responsible protease and its role in the pathophysiology of TTP remain unknown. We performed genome-wide linkage analysis in four pedigrees of humans with congenital TTP and mapped the responsible genetic locus to chromosome 9q34. A predicted gene in the identifed interval corresponds to a segment of a much larger transcript, identifying a new member of the ADAMTS family of zinc metalloproteinase genes (ADAMTS13). Analysis of patients' genomic DNA identified 12 mutations in the ADAMTS13 gene, accounting for 14 of the 15 disease alleles studied. We show that deficiency of ADAMTS13 is the molecular mechanism responsible for TTP, and suggest that physiologic proteolysis of VWF and/or other ADAMTS13 substrates is required for normal vascular homeostasis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/62592/1/413488a0.pd