Ongoing Development and Evaluation of an Engineering Service Course

George Fox University has a service-learning course required of all engineering program graduates. The course began in 2010 as a one-credit per semester, four-semester sequence starting in the spring of the sophomore year. This structure provided an overlap of students in their first and second year in the course. All student teams met concurrently one evening per week to work on faculty-provided projects. Each faculty member was responsible for approximately four teams. Faculty and students began each year of the program with excitement, but over time, a number of significant challenges emerged, among these the explosive growth of the George Fox University engineering program and its potential effect on the sustainability of the program. Therefore, in this paper we follow-up on our published review of the first few years of the program. Here we discuss the mechanics of these changes and their continuing effect on the overall program. An increasing number of students necessarily required an increasing number of projects. Faculty had already expressed difficulty in managing four projects and in finding clients with appropriate engineering challenges. Faculty had also recognized that some students lacked motivation to participate in some of the provided projects, especially during their second year of the course. To meet these challenges, the course was restructured as a two-credit per semester, two semester sequence in the junior year. This cut the number of students (and therefore projects) in half. Faculty were generally assigned to oversee one team. Finally, the task of finding projects was given to the incoming juniors who became responsible to propose and present projects for instructor approval. In addition to describing the evolution of the program, statistical analyses of student perceptions of the design process and the influence of service experiences will be presented. These longitudinal data are used in the evaluation of the program as well as the overall presentation of the design process in the engineering curriculum. The details of this paper will provide information to other programs in their development of similar courses. Through the discussion of ongoing areas of concern, those implementing similar programs will gain exposure to issues that are sure to arise

Preparing Engineers for Service

George Fox University has a strong service mentality. As the result of the university’s “Serve Day” at the Oregon School for the Blind, faculty members developed a passion to connect engineering students with service opportunities that require a technical solution. In the spring of 2010, the engineering department initiated a course sequence required for all engineering students. The program affiliated with the EPICS program (started at Purdue University) and utilized much of their course material for documenting the design process. Students’ initial excitement for the course waned as they began to feel burdened by the large documentation requirements; the instructors agreed with their assessment. In this servicelearning context, the intention was to emphasize service, however academic demands dominated. Because of the hands-on design-and-build curriculum, the instructors felt that students could perform effectively as engineers without additional “academic” material overhead. Thus, much of the documentation requirements were curtailed. When the requirements eased, student passion returned; yet, the instructors soon discovered that with this excitement came reduced project performance. Though the faculty was teaching the design process and engaged students with multiple projects throughout the curriculum, students had not effectively learned how to develop project requirements and specifications. Therefore, the instructors revamped the approach and implemented a detailed design-cycle template with a weekly assessment form using Google Apps. The students were not enthusiastic about the added documentation requirements, but they recognized that these processes enabled them to achieve their goal of providing service to others. In this paper the authors detail the development of a service-learning course, recounting the various changes in the approach. They suggest that this learning is a prerequisite for effective engineering service and emphasize that if students are to serve, they must first learn

Using domain-independent problems for introducing formal methods

The key to the integration of formal methods into engineering practice is education. In teaching, domain-independent problems i.e., not requiring prior engineering background-offer many advantages. Such problems are widely available, but this paper adds two dimensions that are lacking in typical solutions yet are crucial to formal methods: (i) the translation of informal statements into formal expressions; (ii) the role of formal calculation (including proofs) in exposing risks or misunderstandings and in discovering pathways to solutions. A few example problems illustrate this: (a) a small logical one showing the importance of fully capturing informal statements; (b) a combinatorial one showing how, in going from "real-world" formulations to mathematical ones, formal methods can cover more aspects than classical mathematics, and a half-page formal program semantics suitable for beginners is presented as a support; (c) a larger one showing how a single problem can contain enough elements to serve as a Leitmotiv for all notational and reasoning issues in a complete introductory course. An important final observation is that, in teaching formal methods, no approach can be a substitute for an open mind, as extreme mathphobia appears resistant to any motivation

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Present at the Creation

Early leaders of the GOP, Clarke Reed, Wirt Yerger, Mike Retzer, and Ebbie Spivey talk about how they got their party started in Mississippi and watched it grow into a dominant force. Overby Fellow Bill Rose moderates